OB ATI: Chapter 17 - Postpartum Physiologic
Adaptations Detailed Questions and Expert
Answers
Postpartum Physiological adaptations - ANS This maternal recovery period starts
with delivery of the placenta and includes at least the first 2 hr after birth.
Also during this stage, parent-newborn bonding should begin to occur.
The main goal during the immediate postpartum
period is to prevent postpartum hemorrhage.
.Other goals include assisting in a client's recovery, identifying deviations in the
expected recovery process, providing comfort measures and pharmacological pain
relief, providing client education about newborn and self-care, and providing baby-
friendly activities to promote infant/family bonding
Puerperium (postpartum period) - ANS The postpartum period, also known as the
PUERPERIUM,
includes physiological and psychological adjustments.
This period is the interval between birth and the return of
the reproductive organs to their normal nonpregnant state.
Although traditionally this has been considered to last 6
weeks, this timeframe varies among women
●Physiological changes consist of uterine involution;
,lochia flow;
cervical involution;
decrease in vaginal distention;
alteration in ovarian function and menstruation;
and CV, urinary tract, breast, and GItract changes.
●Greatest risks during the postpartum period hemorrhage, shock, and infection
●Oxytocin (a hormone released from the pituitary gland)
coordinates and strengthens uterine contractions.
◯ Breastfeeding stimulates the release of endogenous
oxytocin from the pituitary gland.
◯ Exogenous oxytocin can be administered postpartum to improve the quality of
the uterine contractions. A firm and contracted uterus prevents excessive bleeding
and hemorrhage.
◯ Afterpains: Uncomfortable uterine cramping
●After delivery of the placenta, hormones (estrogen,
progesterone, and placental enzyme insulinase)
decrease, thus resulting in decreased blood glucose,
estrogen, and progesterone levels
○ decreased estrogen is associated with Breast engorgement,
diaphoresis (profuse perspiration),
and diuresis (increased formation and excretion of urine) of excess extracellular
fluid accumulated during pregnancy
, Local dryness and intercourse discomfort can persist until ovarian function returns
and menstruation resumes.
○decreased progesterone is associated with An increase in muscle tone
throughout the body
○decreased placental enzyme insulinase associated with Reversal of the
diabetogenic effects of pregnancy, which lowers blood glucose levels immediately
assessments - ANS Postpartum assessments immediately after delivery Include
monitoring V/S,
uterine firmness and its location in relation to the umbilicus, uterine position in
relation to the midline of the abdomen, and amount of vaginal bleeding.
● Recommended that BP and pulse be assessed at least every 15 min for the first 2
hr after birth.
Temperature should be assessed every 4 hr for the first 8 hr after birth and then at
least every 8 hr.
A Focused postpartum physical assessment
Should include assessing the client's
● B: Breasts
● U: Uterus (fundal height, uterine placement, and consistency)
● B: Bowel and GI function
● B: Bladder function
● L: Lochia (color, odor, consistency, and amount [COCA])
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